DEPARTMENT OF EDUCATION

BUREAU OF INSTRUCTIONAL SUPPORT AND COMMUNITY SERVICES

District Autism Contact Persons’ Meeting

January 17, 2003

Response Form

Please fax this form to Mike Muldoon at (850) 922-7088 no later than January 3, 2003.

District:

Name: Title/Position:

Phone: E-mail:

I will be attending the District Autism Contact Persons’ Meeting on

January 17, 2003, in St. Petersburg.*

I will not be attending the District Autism Contact Persons’ Meeting on

January 17, 2003, in St. Petersburg.

*Individuals attending this meeting must also complete the registration form for the CARD